Nagamoto N, Saito Y, Sato M, Sagawa M, Kanma K, Takahashi S, Usuda K, Endo C, Fujimura S, Nakada T
Department of Surgery, Tohoku University, Sendai, Japan.
Am J Surg Pathol. 1993 Dec;17(12):1234-43. doi: 10.1097/00000478-199312000-00004.
Nineteen cases of isolated squamous cell carcinoma in situ (CIS) of the bronchus were described clinicopathologically from among 149 male heavy smokers with roentgenographically occult lung cancer discovered mainly by mass screening performed from 1982 to 1991. All 19 patients had positive sputum cytology tests and negative chest x-ray films and underwent lobectomy (except one who had segmentectomy because of poor lung function). Prior to operation, localization was accomplished by one to eight bronchoscopies using repetitive brush cytology and biopsy. Five cases were bronchoscopically invisible. Polypoid protuberance was noted in three cases, micronodular swelling in three, thickening of spur in five, and mucosal granularity in three. Histology by serial block sectioning showed that there was no nodal involvement in any cases; the maximum length or diameter was 12 mm. Thirteen tumors were < or = 4 mm, four of which were confined to the spur where they occurred. Follow-up data showed a favorable prognosis. Segmentectomy or sleeve resection of bronchus without mediastinal lymph node dissection may be adequate for CIS.
对1982年至1991年间主要通过大规模筛查发现的149例男性重度吸烟者中，经临床病理描述的19例支气管孤立性原位鳞状细胞癌（CIS）进行了研究。所有19例患者痰细胞学检查均为阳性，胸部X线片均为阴性，并接受了肺叶切除术（1例因肺功能差行肺段切除术）。术前通过1至8次支气管镜检查，采用重复刷检细胞学和活检进行定位。5例支气管镜下不可见。3例可见息肉样隆起，3例为小结节状肿胀，5例为嵴增厚，3例为黏膜颗粒状。连续切片组织学检查显示，所有病例均无淋巴结转移；最大长度或直径为12mm。13个肿瘤≤4mm，其中4个局限于其发生的嵴部。随访数据显示预后良好。对于CIS，不行纵隔淋巴结清扫的支气管肺段切除术或袖状切除术可能就足够了。
